I am interested in any training progams for the buttonhole technique for daily home dialysis. Any input is graciously appreciated. Also, does Medicare pay for home hemo. I am in Florida and we don't seem to have any programs here. I am trying to anticipate being emancipated as a patient, self directed and medicated. Any histroy of similar treatment. this site is wonderful.

Contact Medisystems. They came out to our unit a few months ago and did a great presentation on buttonhole. We now have 6 patients using the technique. All but 2 of them are sticking themselves.

Medisystems is listed in the Renalweb yellow pages or you can go to the Medisystems website, medisystems.com

Do you mean the other two are doing the buttonhole, but the techs are sticking them? Thanks for this info. I've been trying to find someone to teach me.

Yes. The other two are patients that can not or choose not to stick themselves. The patients that are sticking themselves all began self care after they learned how to do the buttonhole method. Prior to that they were stuck by the staff. All are quite happy with the technique.

Had missed this response and just saw it. This is interesting because I've read a number of times that with the buttonhole technique the patient has to stick himself as another person can't get the angle consistently. So if I'm understanding you correctly someone wanting to do the buttohole tech. but who either doesn't feel comfortable sticking himself or is unable to for whatever reason, can be stuck by a tech in the unit or a caregiver at home.

Buttonhole cannulation on Native AV Fistulas can be performed by dialysis staff, home partner or the patient themselves.

If the patient is going to be the person cannulating the access in the long run, but the sites are being initiated by someone else, sites should be selected with the patient's ability to cannulate them in mind.
It has been my experience that this is a critical factor in the success of self cannulation using the buttonhole technique.